Can you tell me about Raynaud's disease?

These fluctuations in blood flow are most noticeable in the skin. We flush pink when the skin's blood flow is high, as occurs to shed heat...

Question

I have been diagnosed with Raynaud's disease and am looking for information.

My symptoms include being cold most of the time, especially my hands, feet and nose. I have to wear socks in bed! Last winter my hands were cold even with two pairs of gloves.

My fingers can be quite painful even just picking up cold food from the supermarket shelves (often increased by overactive air conditioning) causing my fingers to turn white and bright red at the tips.

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They then swell afterwards when warmed; the tips have even turned black if I am in a situation when I cannot warm them up quickly. I have been advised to take a drug to help with the circulation, a vasodilator, but am worried about any side effects.

Also, is being generally cold all the time and needing extra layers when others are fine in a t-shirt a typical symptom of Raynaud's?

If you can give me any further information or resources I can use for further information it would be very much appreciated.

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I wonder if it is also possible that such information be included in your list of diseases on this website.

Answer

Blood vessels are not rigid and static tubes.

Those that supply blood to tissues (the arteries) have muscular walls that are capable of constricting (vasoconstricting) and relaxing (vasodilating) to change their diameter.

This allows the body to control the flow of blood to its organs and limbs when adapting to changes in physical circumstance, posture and environmental temperature.

These fluctuations in blood flow are most noticeable in the skin. We flush pink when the skin's blood flow is high, as occurs to shed heat or at times of excitement, and grow pale when the flow is restricted to conserve core body heat or to maintain blood pressure at times of stress.

Restriction of blood flow due to vasoconstriction can often be seen in the fingers and toes too. Most folk notice this on cold days, but the extent to which it happens seems to vary between individuals.

Raynaud's disease is a condition in which the blood flow to the fingers is restricted by excessive, inappropriate vasoconstriction, with little provocation.

The exact cause is not understood, but the effect is as you have described it; cold, white fingers, that eventually turn blue and then red with pins and needles, pain and numbness. In the worst cases this can lead to damaged skin on the fingertips and it has been known to affect the tip of the nose too.

Sometimes it happens as a consequence of another condition and in this context it is described as Raynaud's phenomenon. There are many conditions that can cause it, but most of them are rare.

They are usually diseases in which the immune system is faulty and prone to attack its own tissues (autoimmune disease), such as rheumatoid arthritis, systemic lupus erythematosis (SLE) and scleroderma, or diseases that obstruct and damage blood vessels directly.

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Apparently, even a severely underactive thyroid gland can be responsible. Obviously any underlying conditions need to be detected and treated.

Treatment for the problem itself really involves keeping the extremities warm and trying to avoid the conditions that make it worse; such as cold, physical knocks and vibration.

Minimising emotional stress has a significant beneficial effect too. It is important to avoid drugs that are known to restrict blood vessels.

There are medications that relax muscle in the walls of arteries and counter any restriction of blood flow (vasodilators). These are relatively safe and can be quite effective, nifedipine is one medication that is commonly used.

Their other effects include lowering blood pressure, constipation and swollen ankles, but usually these are mild and reversible - so whether you take them or not depends on the overall level of benefit.

There are other drugs and even operations that can be tried in severe cases. Sympathectomy is a procedure that cuts those nerves that signal the blood vessels within a limb to vasoconstrict. It is very effective, but doesn't necessarily last forever.

Generally speaking, the sort of symptoms you describe would normally be investigated. Feeling 'bodily cold' doesn't necessarily go with the disease and it just raises for me the possibility that an underlying condition needs to be ruled-out.

Every patient is different and it is important to keep in touch with your own GP or specialist about your symptoms. This winter you're going to need good warm gloves and mittens, socks and boots.

I hope you make some progress with the treatment on offer and your condition improves. Good luck.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.

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